Laparoscopic sacrocolpopexy in the management of recurrent pelvic organ prolapse

Najib, Bernard; Rusavy, Zdenek; Abdallah, Wael; Deval, Bruno

doi:10.1016/j.jogoh.2023.102651

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Alternative laparoscopic surgical techniques, such as pectopexy [ 16 , 17 , 18 , 19 ] or lateral suspension [ 20 , 21 ], do not treat all compartments and do not have higher objective and subjective long-term success rates compared to SCP [ 17 , 19 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Outcome data on reSCP are also limited. Alternative surgical intervention techniques such as pectopexy [ 16 , 17 , 18 , 19 ] or lateral suspension [ 20 , 21 ] do not treat all compartments and have inferior long-term data compared to SCP [ 17 , 19 , 21 , 22 ]. Vaginal treatment options, including vaginal native tissue repair, correcting the anterior [ 23 ] and/or apical compartment [ 24 ], have lower long-term success rates compared to the abdominal approach [ 22 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Recurrent Pelvic Organ Prolapse after Sacrocolpopexy—A Surgical Challenge

Studer,

Faehnle-Schiegg,

Frey

et al. 2024

JCM

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Background: Repeat sacrocolpopexy (reSCP) for recurrent pelvic organ prolapse (POP) is a rare and complex condition with little understanding of how to manage. Most authors recommend complete reSCP regardless of the underlying cause of the failure. This retrospective cohort study presents our management workflow and how to systematically approach this challenging situation. Methods: From 2017 to 2021, we analyzed all women undergoing surgery for recurrent POP after sacrocolpopexy at our tertiary referral hospital at the department of urogynecology. Preoperatively, all women underwent a structured work-up consisting of answering the validated German female pelvic floor questionnaires, a clinical examination utilizing the POP-Q staging system according to the International Continence Society (ICS), and a pelvic floor ultrasound. The surgical management was based on the preoperative findings and was adapted individually during surgery if indicated according to the estimated underlying problem for recurrence. Results: In total, 377 women underwent a primary laparoscopic sacrocolpopexy. However, ten women presented with a symptomatic recurrent prolapse requiring further surgical intervention. A reSCP was performed in eight women, including two with additional laparoscopic paravaginal repair to correct the displaced mesh placement at initial surgery. A vaginal correction was indicated in two women with an isolated posterior compartment prolapse. The analysis demonstrates that reSCP has a low intraoperative complication rate and high subjective and objective success rates. Conclusions: We could demonstrate that individualized reSCP after initial SCP is a challenging yet feasible and safe treatment option, but there may be suitable alternatives. If women undergo pre- and intraoperative standardized problem-oriented examinations, we can often identify the cause of the recurrent prolapse. Tailored surgery must be subsequently performed.

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